How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $33.11 Median $3,090.30 Typical High $7,762.47 | Facility | None | $33.11 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $45.71 Typical High $79.43 | Professional | None | $25.12 | $45.71 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $54.95 Typical High $93.33 | Professional | None | $31.62 | $54.95 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $52.48 Typical High $83.18 | Professional | None | $31.62 | $52.48 | $83.18 |
Denver HMP Setting Facility Modifier None Typical Low $25.12 Median $45.71 Typical High $93.33 | Facility | None | $25.12 | $45.71 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $45.71 Typical High $79.43 | Professional | None | $23.99 | $45.71 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $43.65 Median $46.77 Typical High $97.72 | Facility | None | $43.65 | $46.77 | $97.72 |
Select Health Setting Professional Modifier None Typical Low $15.49 Median $42.66 Typical High $91.20 | Professional | None | $15.49 | $42.66 | $91.20 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $32.36 Median $54.95 Typical High $100.00 | Professional | None | $32.36 | $54.95 | $100.00 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $20.89 Typical High $22.91 | Professional | 52 · Reduced service | $12.59 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $8.32 Typical High $9.12 | Professional | 53 · Discontinued | $5.13 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $30.90 Typical High $33.88 | Professional | 54 · Surgery only | $19.05 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.17 Typical High $6.92 | Professional | 55 · Aftercare only | $3.80 | $6.17 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.17 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.51 | $4.17 | $4.57 |
Where Colorado sits
The same service costs 3.4 times more in Wisconsin than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Colorado· 16th of 51
$61.66
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.